Sunday, March 21, 2010

That's the title of an op-ed by The Washington Examiner published tonight.

Despite more than a year of steadily rising public opposition, manifested in opinion polls and in protest rallies across the country, President Obama, Senate Majority Leader Harry Reid and House Speaker Nancy Pelosi finally rammed through Obamacare late Sunday when House Democrats gave the bill their imprimatur.

The House vote isn’t the end of the national debate on this issue, however, as the Senate still must accept the House changes in the Senate Obamacare bill. Senate Republicans argue that the House reconciliation bill that makes significant changes in the Senate bill violates the Congressional Budget Act of 1974, maintaining that it should be ruled out of order by the Senate parliamentarian for consideration in the upper chamber. That in turn would mean the only bill the president could legally sign would be the original Senate bill, with its massive funding of abortion and the infamous deals used to buy senators’ votes, including the Cornhusker Kickback. At that point, a constitutional crisis of historic magnitude seems inevitable.

Never before in American history has a measure of such importance been imposed on the country by the majority party over the unanimous opposition of the minority.

A fast-track challenge to Obamacare’s constitutionality will likely reach the Supreme Court in coming months. The justices will have multiple issues to consider, including the unprecedented federal mandate that all individuals buy approved health insurance, the undeniable inequity of the many corrupt bargains used to buy votes for the measure, and the banana republic parliamentary tactics used by the Democratic congressional leadership. Whatever the high court’s decision, it won’t be nearly as unpleasant as the verdict many Democrats will hear from their constituents in November.

We have not seen the end of this controversy, not by a long shot. Big Government's days are numbered. If ever there were a reason to believe that politics is shifting to the right, and in a direction more favorable to business, free markets, and individual liberty, it is now.

We are a consumer based economy now driven by govenment deficit spending at the Federal, State and Local level. Well over 150 million Americans depend on a government to generate an income and spend.

This present situation occured over the past thirty years and accelerated to light speed under Bush.

I am not sure what world you are living in....but if government is not spending in America, we really have not much of an economy left.

We make a few planes, a couple pieces of machinery, occasionally some decent movies, and export lots of grain and trash filling up empty containers going back home.

I am not sure if you have noticed, but auto sales and home sales are both declining on the margin over the past three months......you were the one who taught how to observe the margin.

Passing this health are bill was insane....practically every city, county and state are downsizing....so are most public and private employers, or at least maintain a freeze on hiring. Our college grads have few places to land other than bartending or serving food....and we are shoving health care down America's throat....we don't even have the money to pay the politicians who passed this nonsense legislation on a Sunday night.

It is interesting how we can be running such a massive deficit and there are idiots out there trying to spend even more.....often trying to compare America's deficit today to WW2 when we had a tiny GDP, very little private debt which was easily able to absorb the debt, and a foundation to become the worlds manufacturer for a number of years.

At this point, the only way out now seems like a massive escalation in military spend.......based on current rhetoric and troop movements, we should not be too far away.

I wish the right-wing had been so on fire when, maintained over the decades, we created the Red State Socialist empire, stretching from Alaska, down through Montana, and into the desert West and Appalachia, A couple hundred billion dollars a year in crop subsidies, rural highways, telephone subsidies, postal service, water and power systems, airports, railroad stops and more.

When our foreign policy has gotten so far from "avoiding foreign entanglements" (as our founding fathers advised) that Obama is now propping up a narco-state in Afghanistan, why no hue-and-cry from those who want small federal government? BTW, the other state we run is Iraq, where we replaced a secular tin-pot dictator ( who had no WMG, navy or air force) with a Shiite Islamic theocratic state, now very friendly with Iran. No right-wing ire over this?

Small federal government? We are running three countries now: Iraq, Afghanistan and (sometimes) the USA. Can we cut it down to one? That, at least, would be smaller.

And what is small about a military that cannot a field a single soldier for less less than $1 million a year--in marginal costs? The real cost is certainly multiples of that. Can we have a small government in our military? Russia demobilized, much to the benefit of their country/ They reduced the size of their government, freeing up energy and human capital for the private sector. We can't do the same?

When Bush got his Medicare drug program, where was all the rancor then? Why was not Bush a socialist, and incentive-killer, or worse? Did Bush tell America to "drop dead."? (Well, some say he killed the economy, but that is not the same).

When AIG could not honor the bond insurance it sold (and collected premiums from, and made profits from) and Bush saved them, where was the rancor then?

Truth to tell, I think Obamacare is a bad idea, for the same reason our entire health care system is doomed: We do not ration care.

That's right. Ration care.

We keep very elderly and dying patients "alive" for a few weeks or months at the end of their life. The R-Party wanted to keep Terri Schiavo "alive" for another few decades. Imagine the cost of that.

There is no way private insurance can cover such costs, and no way Medicare can cover such costs. We have to start pulling the plug.

The R-Party has a real problem with this, as they have adopted an extremist position that all life is sacred, even that of a vegetable who died years earlier, though her body can be kept functioning (Schiavo). A special session of Congress was convened, and Bush cut a vacation short (!!!!) to try to force a federal intrusion into the private life of this poor guy in Florida, Schiavo's husband. I guess DC Republicans had concluded that Schiavo's husband, the doctor, the hospital, and the state of Florida were all in cahoots to murder the woman.

Small government anyone? Except when the feds intrude on the private decisions of family, doctors and hospitals in Florida? That was a very ambitious interpretation of federal power by DC Republicans.

There is this conflict in health care, and the private sector cannot solve it: How to pull the plug. You want people to pull the plug, based on the cost only? Private-sector insurers want to pull the plug pronto. Maybe too soon.

Better a rational, impartial observers make the decision to pull the plug--sooner than now, but not too soon. As long a Medicare and private payers keep paying, that's how long hospitals will keep the cadavers pumping.

Or, we can play "let's pretend." Let's pretend goes like this: We pretend we can give everybody all the care possible, until they die several weeks or a few months or even years past their expiration date. And we spend 30 percent of GDP on health care, or maybe more, as we know have baby boomers entering the doddering years (including me soon).

Really, we should go to single payer, with rationing. Obama does not propose enough reform, only add-ons.

“I am not sure what world you are living in....but if government is not spending in America, we really have not much of an economy left.”

That’s a rather contorted view as the government doesn’t exist, and hence the spending doesn’t exist, without the private sector first making transfer payments to the public sector. Therefore if the transfer payment was kept by the private sector then the value of the transfer payment would still exist and more than likely be spent/saved/invested in an efficient manner by the private sector. Theoretically, if the transfer payment from the private sector to the public sector was eliminated then the middle man (government) would be eliminated and hence the administration cost of the transfer payment eliminated. Government produces nothing and merely acts as a transfer agent.

Here is an observation: if 40% of the economy is some sort of government expenditure and/or transfer payment-redistribution scheme, and the political class through the mechanism of government consistently mismanages 40% of the economy, you are going to end up with some dismal overall macroeconomic results. At the very least, highly inefficient overall economic results e.g. if GDP is 4% in a quarter it could have been 6% without political class involvement.

It isn't so much the "government" that creates dismal results, its the political class using the mechanism of government to carry out their loony tune economic propositions. Economics based on "notions" rather than sound empirical evidence.

Why does Benji feel compelled to chime in with a "Republicans are the problem" post every time Scott points out the disastrous, bankrupt policies of the easily identifiable socialist Benji voted for?

This time Benji even endorses a single payer system even while hurling his lame "Red State Socialist" epithet at the rest of us who weren't dumb enough to vote for the official candidate of People Magazine.

Centrists appear to like this bill. http://www.nytimes.com/2010/03/22/opinion/22krugman.html?hp

It will be interesting to see how this plays out. I do not think the disapproval is as widespread as Rasmussen would have it. Their polls tend to lean to the right anyway. I think it is the right-wing and the left-wing that don't like it. The center wants to try it.

I find the argument that the bills must be repealed before people experience the benefits, an intriguing one. The argument was made by a commenter here and reveals a sort of anti-market sentiment. If the electorate might find that the benefits are worthwhile why should there be an attempt to take the good away from the buyer before she/he can make a decision, based not on some abstract political argument, but on what the benefit/cost assessment is?

Doug: that article is woefully naive in its understanding of the healthcare bill just passed. If it is not repealed or declared unconstitutional, it will lead to a government takeover of healthcare as surely as day leads to night.

Try smoking for a few months to see if you like it. Better yet, try cocaine. Give it a good long, fair trial.

Whenever government takes over a sector of the economy, powerful constituencies are created that make it impossible to reverse course. For this program, the "benefits" don't start to flow until 2013. The tax increases and Medicare cuts start soon. This creates a window of opportunity to reverse course that will stay open two and a half years.

There is only one way to handle the deficits that will result from Obamacare: a large VAT combined with painful rationing of medical care for the middle class. The Democrats have kicked this can down the road but it's there and will have to be dealt with.

Can the federal government ever exit its near total control of the ag sector? What about the worthless ethanol program?Can we ever pare back our military and foreign policy complex (which has convinced our President we have to occupy and re-invent not just one but two nations on the far side of the globe, including the narco-state of Afghanistan)?I doubt it.Yes, health care will be a boon-doogle too.If you like our ag sector, if you like the US military-firegn policy crowd, then you will love health care going forward.My point is that the new Republicans are far cry from the R-Party of the 1950s, and Robert Taft and Eisenhower. They were Republicans who truly feared a bigger federal government, and deficits.But the R-Party became decadent. Who can take seriously R-Party caterwauling about deficits now? It is like watching the brothel girls look down on streewalkers for being cheap.

The Tea Party is interesting, and I hope for the best. But I have yet to hear a T-Partier call for a reduced military, an end to Red State subsidies, the elimination of ethanol, the elimination of home mortgage interest tax deduction, or an embrace of Milton Freidman's favored form of taxation--a progressive consumption tax. If the R-Party had truly been a bulwark against federal fat and expansion in the last five decades, if would have the moral gravity and strength to perhaps keep government small. Sadly, the R-Party has been a perpatrator of federal epxansionism.Any party that thinks it can intrude into the private decisions surrounding Terri Schiavo, or that implemented the travesties attending modern airline travel, and occupied two nations on the far side of the globe, is not the party of small government.

Ben: You are a broken record. Many Republicans and people on the right call for the end to some of all of the government subsidies you complain about. Of course, you really do not have legitimate complaints about "Red state socialism" but you simply use this construct as a rhetorical device. It is painfully obvious that you are in fact an actual socialist, my friend. So, let's stop playing games.

I am sorry Charles, the reference to smoking and cocaine went by me, honestly. Could you explain?

Scott, Krugman may indeed be naive about many things, but I don't know what you mean by "government takeover of healthcare." This is one of those huge undefined slogans that only obscure the discussion.

On another note, what would, in the real world, be the result of ending farm subsides? I ask this as a real question, not just trying to start a new argument. Currently subsides seem to favor large factory farms, the small farmers trying to grow and sell locally and organically seem to be left out of the equation.

Gabriela, it seems to me that there does not exist any incentive within the power (= money) elites. As long as politics is wedded to money through elections politics will be beholden to whoever the politicians deem capable of financing their re-election. I would love to see what would happen if the need to raise money and bootlick for it was eliminated from the whole process.

Douglas: The provisions of the healthcare bill will almost certainly result in a government takeover. Mandating that everyone buys a health insurance policy means that government will end up defining the minimum level of coverage. That minimum level will almost surely mean a very high level of coverage (lobbyists will ensure that result). The bill also says that if anything in your current policy changes, then you will have to buy a government-defined policy. Allowing people with pre-existing conditions to buy policies will result in massive numbers who refuse to buy a policy until they are sick. That will either result in gigantic deficits, or more expensive policies for everyone else. Rather than up premiums, the government will hand out more and more subsidies. Sooner or later someone will realize that's it's easier to just nationalize the whole thing. The healthcare bill either a) contains the seeds of its own destruction, or b) is constructed so as to inevitably lead to a single-payer nationalized system.

Ending farm subsidies would be an incredibly fantastic thing for everyone except those currently receiving the subsidies.

Money and politics can never be separated unless and until we reform the tax code to eliminate all deductions. If lobbyists can't exploit the tax code, then the demand for lobbyists will evaporate and the ability of money to influence politics will fall to de minimis levels. Follow the money; follow the incentives. That's the best way to fix things.

Bill-I am a "socialist" who wants federal outlays maxed at 17 percent of GDP, and end to the Red State Socialist Empire, a downsized military (Cato Institure recommends this), an end to the homeowners mortgage interest tax deduction (vast overinvestment in housing), and I support Milton Friedman's progressive consumption tax to balance the federal budget.

I do not support Obamacare, and think no federal employee, whether in the military or any other agency, should be able to retire after just 20 years of service.

I wuld liek to wipe out th Department of Education and the USDA.

Okay, I am a socialist--I have a weak spot for our national parks.

I could throw around brickbats too--you are a nationalist-militarist-socialist, a flagwaver who salutes uniforms, not the ideals that are supposed to be protected by the uniform.It is easy to throw brickbats, but let's hope we can argue consistent concepts. If you have a different point of view from me, let's hear it.

Hey txsaddletramp I hear you on that, as long as we can afford to buy the coverage. I have been self-employed for almost all of my working life and stopped buying health insurance when it went over $750 a month.

I support a single-payer system which would eliminate the health insurance industry altogether. I think of it as getting healthcare protection just as I get police protection, I go to a nurse practitioner near me that I like and the agency charged with paying pays her. There has been an Insurance Industry Takeover of healthcare and I don't understand how that is qualitatively better than having the system paid through a government agency. Is it any better having a predatory private entity in possession of my personal information ready to sell it to the highest bidder? I don't see why a large organization is bad when it is a government organization and good when it is a private organization. We have seen ample proof lately that the private sector can be as corrupt and destructive and venal as people claim to be worried that the government would be.

It seems to me that this issue is an amazingly difficult nut to crack and all the facile slogans and rhetorical catch-phrases either on the right or the left don't help things.

I must have missed something important - maybe I'm late to the game. But I haven't read anything Benjamin has written to merit the attacks. I do see that his posts at least include substantive, and yes interesting, arguments.

BTW, I am as angry about the health care bill as anyone. Primarily because I see my children (16,13) being saddled with a country burdened by huge debt and an entitlement society that creates all the wrong incentives. I remember reading a social scientist writing how amazing it was to watch Italy commit societal suicide because of low birth rates. I feel the same way about our current direction - we've seen what entitlement policies along with declining productive population gets you (most of western Europe and Japan). We know where it’s headed – it’s no secret. The liberals have accepted the tradeoff of a declining society in return for a more “civilized” society. Personally, I see the merits of some form of universal health care, and maybe even single payer. But with an entirely different set of incentives. Any such system should be geared to promote the productive members of society, for society’s own benefit.

Public: mandatory car insurance is VERY different from mandatory health insurance.

Mandating the purchase of car insurance (something I'm not necessarily in favor of) in order to protect others from the consequences of one's actions is not entirely unreasonable; if you don't want to buy insurance, don't drive, or move to a state that doesn't require it.

Mandated car insurance is almost always a minimum policy with a low premium; mandated health insurance will almost certainly be a premium policy with a low deductible and very high premium.

Mandating that people buy health insurance just because they are alive gives you no alternative, and that is without historical precedent and not a power to be found anywhere in the constitution. It's a very slippery slope to more government control over more of our lives.

You can buy car insurance from any company in the country, whereas health insurance currently is available only from a company within the state you live in.

Since the car insurance you buy most likely covers a lot more than just the minimum required by your state, there is plenty of room for competition.

Finally, I would note that the price of car insurance is largely determined by a) your driving record (read: your health habits), and b) the type of car you are insuring (read: pre-existing conditions). The healthcare reform bill would effectively outlaw any such steps to tie the cost of the policy to the health of the individual.

"Though Obamacare will inflict billions in new taxes on individuals and employers, at least it creates some jobs: the IRS might have to hire as many as 16,000 new employees to enforce all the new taxes and penalties the bill calls for! And that doesn’t include all the other government jobs from the 159 new agencies, panels, commissions and departments this bill will create. As the private sector shrinks, we can count on government to keep growing along with the deficits needed to keep it all afloat. (Is this the kind of “change” Americans asked for?)

In the end, this unsustainable bill jeopardizes the very thing it was supposed to fix – our health care system. Somewhere along the way we forgot that health care reform is about doctors and patients, not the IRS and politicians. Instead of helping doctors with tort reform, this bill has made primary care physicians think about getting out of medicine. It was supposed to make health care more affordable, but our premiums will continue to go up. It was supposed to help more people get coverage, but there will still be 23 million uninsured people by 2019."

"For example, now I don’t have to worry that if my brother retires before he is eligible for Medicare, he won’t be able to buy health insurance due to a pre-existing condition."

saddletramp: Why exactly should I be forced to pay for your brother's failure to prepare financially for unforeseen medical needs or for his family's failure to come to his aid? Since I do not know your brother and he is your brother it seems far more fair for you to provide his care than for me to do so. So, get off the internet and get to work...

"I am a "socialist" who wants federal outlays maxed at 17 percent of GDP, and end to the Red State Socialist Empire, a downsized military (Cato Institure recommends this), an end to the homeowners mortgage interest tax deduction (vast overinvestment in housing), and I support Milton Friedman's progressive consumption tax to balance the federal budget."

Ben: So what in the world led you to believe that Obama would give you your supposed political wants? Nothing in his background or political record indicates that he supports any of these things (except perhaps for an evisceration of the military). By the way, I do not support agricultural subsidies or mindlessly support the military so you can stop repeating this canard.

Paul: I still don't think Sarah Palin is ready to be President, but I keep being impressed by some of the things she has to say. If she keeps improving we might find that she is a very viable candidate at some point. I'm reminded of the many years that Reagan spent on the lecture circuit and writing editorials; he ended up extremely well prepared for the job.

"Why exactly should I be forced to pay for your brother's failure to prepare financially for unforeseen medical needs or for his family's failure to come to his aid?"

Bill, if you really believe this then you should shed your health insurance policies right away, because this is exactly how insurance works, with pooling of resources so that if Joe gets sick while Bill stays healthy Bill helps pay for his treatment. I hardly think it necessary to explain this to you, but it seems that you choose to ignore this point. I am willing to bet that you know relatively few of the people who are making use of your premiums, or of those who will be paying for your care should the need arise.

Paul, Ms. Palin is wrong on at least one point: I can tell you from personal experience that healthcare providers have been leaving the profession and discouraging others from entering it for a long time, mostly from frustration at the intrusion of insurance companies into more and more aspects of care. Healthcare hasn't been only about only doctors and patients for a long time, since the 90s at least. It has been about the Insurance companies controlling the doctors/patient relationship in search of profits. It has been about direct marketing of drugs to consumers... what's that about anyway? Does that mean I know how to administer them or is it that I might insist my doctor use a particular drug. Etc.

For what it is worth here is a comment from a friend who has spent much of his life working in the healthcare establishment toward the goal of improving the quality of care.

"This is really big reform, much of it not in the headlines. Adding 32 Million to coverage is huge.

The CMS innovation center and other efforts to change how health care is paid for may well lead to the end of the fee for service system and more coordinated care which will do much not only to restrain costs but improve quality. More care is not necessarily better care.

Douglas: Umm, you are forgetting the critical difference between the government healthcare scheme and health insurance: participation in the health insurance market is voluntary. I have agreed to enter into a contract with my health insurance company freely and voluntarily because it is in my family's best interests to do so. I have not agreed to be descend into the socialist morass of Obamacare.

Well, Bill I am not going to defend the mandatory aspect of it, but the fact remains that voluntarily or not you are paying for the care of unknown others and they are paying for your care. It is how insurance works.

A government healthcare scheme could have been voluntary. I find the mandatory part to be a major stumbling block, but mostly because I am being forced to pay into a private insurance company with=out the alternative of buying into a "public option".

I still don't understand Charlie's reference to smoking and cocaine...

"It has been about the Insurance companies controlling the doctors/patient relationship in search of profits."

It does not follow that Obamacare is the answer. The GOP offered up plenty of market based fixes. Now it's going to be about the government controlling the doctor/patient relationship in search of power, and avoiding financial collapse. My family is going to get crappier care at a higher price, and pay higher taxes for the privelege.

"Now it's going to be about the government controlling the doctor/patient relationship in search of power, and avoiding financial collapse. My family is going to get crappier care at a higher price, and pay higher taxes for the privelege."

Paul, that is, of course, speculation, maybe right maybe wrong. I grant you that so-called "Obamacare" is not the only way to do it, but market-based fixes have been tried and clearly they didn't work, so now we'll try something else, apparently.

I got this from a friend this morning: http://www.cnn.com/2010/OPINION/03/24/jost.health.bill.challenges/index.html?hpt=T2 I would say we are in for some interesting months between now and the Fall election cycle. Boy, am I glad I don't watch TV or listen to radio, because the din is going to be pretty amazing.

Doug: you say "market-based fixes have been tried and clearly they didn't work," but I say that's not true. Market-based fixes don't stand a chance when the government continues to massively distort the healthcare market. How? Two big examples: 1) by allowing only employers to deduct healthcare insurance costs, and 2) by setting or heavily influencing prices for a huge swath of the healthcare industry via medicare and medicaid.

Well, then taking about "market-based" changes is silly. Medicare/medicaid is not going away. I would appreciate being able to deduct health insurance premiums from my income as I am self-employed, but I don't see that happening.

If competition is a good thing why was did so many people have their shorts in a knot over a voluntary "public option"? Maybe having millions of folks buying into Medicare would improve it's outlook, and provide some needed competition for the insurance industry.

Doug: The most important and critical healthcare reform is changing the tax code to either allow everyone to deduct healthcare insurance or no one. Unfortunately that was completely missing from the Democrat's bill. As you suggest, this means we are not going to fix the mess. Very sad, and very unfortunate.

As for the "public option," how do you think that having the government compete with private insurers would increase competition? The government could simply underprice them, and the taxpayers would pay the difference. The public option is simply a disguised method for moving to a single payer system. No competition at all, since the private insurers would either become wards of the state or they would go out of business altogether.